(numbered as per the Prescribed specialised services manual)

1. Adult ataxia telangiectasia services

2. Adult congenital heart disease services

2A. Adult oesophageal gastric services in the form of gastro-electrical stimulation for patients with intractable gastroparesis

3. Adult specialist pain management services

4. Adult specialist respiratory services

5. Adult specialist rheumatology services

6. Adult secure mental health services

7. Adult specialist cardiac services

8. Adult specialist eating disorder services

9. Adult specialist endocrinology services 

11. Adult specialist neurosciences services

12. Adult specialist ophthalmology services  

13. Adult specialist orthopaedic services

14. Adult specialist pulmonary hypertension services

15. Adult specialist renal services

16. Adult specialist services for people living with HIV

17. Adult specialist vascular services

18. Adult thoracic surgery services

19. Alkaptonuria service (adults)

19A. Alpha 1 antitrypsin services (adults)

20. Alström syndrome service (adults and children)

21. Ataxia telangiectasia service for children

21A. Atypical haemolytic uraemic syndrome services (adults and children)

22. Autoimmune paediatric gut syndromes service

23. Autologous intestinal reconstruction service for adults

24. Bardet-Biedl syndrome service (adults and children)

25. Barth syndrome service (adults and children)

26. Beckwith-Wiedemann syndrome with macroglossia service (children)

27. Behçet’s syndrome service (adults and adolescents)

28. Bladder exstrophy service (children)

29. Haematopoietic stem cell transplantation services (adults and children)

30. Bone conduction hearing implant service (adults and children)

31. Pain-related complex cancer late effects rehabilitation service (adults)

32. Children and Young people’s inpatient mental health service

33. Choriocarcinoma service (adults and adolescents) 

34. Chronic pulmonary aspergillosis service (adults)

35. Cleft lip and palate services (adults and children)

35A. Clinical genomic services (adults and children)

36. Cochlear implantation services (adults and children)

37. Complex childhood osteogenesis imperfecta service  

38. Complex Ehlers Danlos syndrome service (adults and children)

39. Complex neurofibromatosis type 1 service (adults and children)  

40. Complex spinal surgery services (adults and children)

41. Complex tracheal disease service (children)

42. Congenital hyperinsulinism service (children)

43. Craniofacial service (adults and children)

44. Cryopyrin associated periodic syndrome service (adults and children)

45. Cystic fibrosis services (adults and children)

46. Diagnostic service for amyloidosis (adults and children)

47. Diagnostic service for primary ciliary dyskinesia (adults and children)

48. Diagnostic service for rare neuromuscular disorders (adults and children)

49. Encapsulating peritoneal sclerosis treatment service (adults)

50. Epidermolysis bullosa service (adults and children)

51. Extra corporeal membrane oxygenation service for adults with respiratory failure

52. Extra corporeal membrane oxygenation service for neonates, infants and children with respiratory failure

53. Ex-vivo partial nephrectomy service (adults)

54. Fetal medicine services (adults and adolescents)

55. Gender dysphoria services (children and adolescents)

56. Gender dysphoria services (adults)

56A. Hand and upper limb transplantation service (adults)

56ZA. Ovarian and testicular tissue cryopreservation for patients receiving gonadotoxic treatment who are at high risk of infertility and cannot store mature eggs or sperm

57. Heart and lung transplantation service (including mechanical circulatory support) (adults and children)   

58. Specialist adult gynaecological surgery and urinary surgery services for females

58A. Specialist adult urological surgery services for men

59. Specialist allergy services (adults and children)

61. Specialist dermatology services (adults and children)

62. Specialist metabolic disorder services (adults and children)

63. Specialist pain management services for children

64. Specialist palliative care services for children and young adults

65. Specialist services for adults with infectious diseases

66. Hyperbaric oxygen treatment services (adults and children)  

67. Insulin-resistant diabetes service (adults and children)

68. Islet transplantation service (adults)

69. Liver transplantation service (adults and children)

70. Lymphangioleiomyomatosis service (adults)

71. Lysosomal storage disorder service (adults and children)

72. Major trauma services (adults and children)

73. McArdle’s disease service (adults)

74. Mental health service for Deaf children and adolescents

75. Mitochondrial donation service

76. NF2-schwannomatosis service (adults and children)

77. Neuromyelitis optica service (adults and adolescents) 

78. Neuropsychiatry services (adults and children)

79. Ocular oncology service (adults)

80. Ophthalmic pathology service (adults and children)

81. Osteo-odonto-keratoprosthesis service for corneal blindness (adults)

82. Paediatric and perinatal post mortem services

83. Paediatric cardiac services

84. Paediatric intestinal pseudo-obstructive disorders service

85. Pancreas transplantation service (adults)

86. Paroxysmal nocturnal haemoglobinuria service (adults and adolescents)

87. Positron emission tomography-computed tomography services (adults and children)

88. Primary ciliary dyskinesia management service (adults and children)

89. Primary malignant bone tumours service (adults and adolescents)

90. Proton beam therapy service (adults and children)

91. Pseudomyxoma peritonei service (adults)

91A. Psychological medicine inpatient services for severe and complex presentations of medically unexplained physical symptoms (adults)

92. Pulmonary hypertension service for children

93. Pulmonary thromboendarterectomy service (adults and adolescents)

94. Radiotherapy services (adults and children)

95. Rare mitochondrial disorders service (adults and children)

97. Retinoblastoma service (children)

98. Specialist secure forensic mental health services for young people

99. Severe acute porphyria service (adults and children)

100. Severe combined immunodeficiency and related disorders service (children)

101. Severe intestinal failure service (adults)

102. Severe obsessive compulsive disorder and body dysmorphic disorder service (adults and adolescents)

103. Small bowel transplantation service (adults and children)

103A. Specialist adult haematology services

104. Specialist burn care services (adults and children)

105. Specialist cancer services (adults)

106. Specialist cancer services for children and young adults

106A. Specialist colorectal surgery services (adults)

107. Specialist dentistry services for children

108. Specialist ear, nose and throat services for children

109. Specialist endocrinology services for children

110. Specialist gastroenterology, hepatology and nutritional support services for children  

111. Clinical genomic services (adults and children)

112. Specialist gynaecology services for children

113. Specialist haematology services for children  

114. Specialist haemoglobinopathy services (adults and children)

115. Specialist immunology services for adults with deficient immune systems

115A. Specialist immunology services for children with deficient immune systems

115B. Specialist maternity care for adults diagnosed with abnormally invasive placenta

116. Specialist mental health services for Deaf adults

118. Neonatal critical care services

119. Specialist neuroscience services for children

120. Specialist ophthalmology services for children

121. Specialist orthopaedic services for children

122. Paediatric critical care services

123. Specialist paediatric liver disease service

124. Specialist perinatal mental health services (adults and adolescents)

125. Specialist plastic surgery services for children

126. Specialist rehabilitation services for patients with highly complex needs (adults and children)

127. Specialist renal services for children

128. Specialist respiratory services for children

129. Specialist rheumatology services for children

130. Specialist services for children with infectious diseases

131. Specialist services for complex liver, biliary and pancreatic diseases in adults

132. Specialist services for haemophilia and other related bleeding disorders (adults and children)

133. Specialist services for severe personality disorder in adults

134. Specialist services to support patients with complex physical disabilities (excluding wheelchair services) (adults and children)

135. Specialist paediatric surgery services

136. Specialist paediatric urology services

137. Spinal cord injury services (adults and children)

138. Stem cell transplantation service for juvenile idiopathic arthritis and related connective tissue disorders (children)

139. Stickler syndrome service (adults and children)

139A. Specialist morbid obesity services for children

139AA. Termination services for patients with medical complexity and or significant co-morbidities requiring treatment in a specialist hospital

139B. Uterine transplantation services (adults)

140. Vein of Galen malformation service (adults and children)

141. Integrated veterans’ mental health and wellbeing service

142. Wolfram syndrome service (adults and children)

143. DNA Nucleotide Excision Repair Disorders Service (adults and children)

Background

The Health and Social Care Act 2012 (as amended by the Health and Care Act 2022) sets out three factors that Ministers take into consideration when they determine which specialised services should be directly commissioned by NHS England:

• The number of individuals who require the provision of the service or facility;
• The cost of providing the service or facility;
• The number of persons able to provide the service or facility.

The Prescribed Specialised Services Advisory Group (PSSAG) gives advice to Ministers on which specialised services should be directly commissioned by NHS England:

The original list of Services for rare and very rare conditions is set out in Statutory Instrument (SI) 2012(2996) and has been subsequently amended through SIs 2014(452), 2015 (415), 2016(293), 2017(296) and 2018(283):

• http://www.legislation.gov.uk/uksi/2012/2996/contents/made
• http://www.legislation.gov.uk/uksi/2014/452/contents/made
• http://www.legislation.gov.uk/uksi/2015/415/contents/made
• http://www.legislation.gov.uk/uksi/2016/293/contents/made
• http://www.legislation.gov.uk/uksi/2017/296/contents/made
• http://www.legislation.gov.uk/uksi/2018/283/made

More detail about the services commissioned by NHS England can be found in the Prescribed Specialised Services Manual.

Fiona Marley, Prescribed Specialised Services Lead
April 2023